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PUSAT SUMBER

SEKOLAH MENENGAH KEBANGSAAN TOH JOHAN


34800 TERONG , TAIPING , PERAK.
BORANG PERMOHONAN PENGAWAS PUSAT SUMBER SEKOLAH 2012
1.

NAMA PENUH : ..................................................................................................................

2.

KELAS : ..............................................................................................................................

3.

ALAMAT : ...........................................................................................................................
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4.

PENGANGKUTAN KE SEKOLAH : .......................................................................................

5.

KEPUTUSAN UPSR / PMR :

BAHASA MELAYU ...............................


BAHASA INGGERIS .............................
MATEMATIK ......................................
SAINS ................................................

6.

JAWATAN YANG DISANDANG SEKARANG 1. PENGAWAS SEKOLAH


2. KETUA KELAS

YA / TIDAK
YA / TIDAK

7.

PERNAHKAH ANDA MENJADI PENGAWAS PSS?

YA / TIDAK

8.

SAYA BERMINAT MENJADI PENGAWAS PSS KERANA ......................................................


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TANDATANGAN PELAJAR,

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(NAMA : ..............................................................................)

@psssmktj2012